Just how far will your medical degree get you in the business world? Not far, analysts say, if your education is not coupled with experience.

Seth Garber, MD, a senior consultant with William M. Mercer Inc. in Seattle, often hears from physicians who want to become consultants. Some of them have both MDs and MBAs, he said. The only problem is that they've never practiced medicine and they've never worked in the business world.

Physicians who want to leave clinical practice often look first to hospitals or health care systems for an executive administrative position. Physicians with only clinical experience might be considered for work in a single-hospital system, said Jennifer R. Grebenschikoff, vice president of the Physician Executive Management Center in Tampa, Fla., but only if they can point to strong leadership experience. Examples include tenure on a credentials committee or voluntarily heading up a local independent practice association.

"If someone comes to me with 20 years of experience as a practitioner but hasn't really done anything in leadership, there's not much I can do," Ms. Grebenschikoff said.

Gigi Hirsch, MD, founder and chief executive officer of MD IntelliNet LLC, a physician consulting and placement company, said that any experience physicians can get beyond the bedside is useful when seeking another career. Physicians who want to enter the pharmaceutical or biotech industries, for instance, should get as much clinical research experience as they can while still in practice. And physicians considering other careers need to spend as much time as possible networking with professionals and executives from other fields.

That's particularly true for physicians over the age of 50, who fall victim to the same hiring biases as the rest of the workforce. Senior physicians find it hard to land entry-level positions in other industries, even with an MBA, Dr. Hirsch said. In a few cases, she has been able to arrange unpaid industry apprenticeships as a way for physicians to get a foot in the door.

And if you are thinking of joining the thriving health care finance industry to take advantage of big stock gains and killer bonuses, be prepared to start over.

"It is appropriate to presume that you would be taking a demotion in seniority, autonomy and compensation to enter the financial community," said Wade H. King, MD, a senior medical technology research analyst for Robertson Stephens, an investment bank in San Francisco. A practicing anesthesiologist for 10 years, Dr. King spent five of those years advising venture capital groups part time about medical technology companies. He also attended Stanford Business School before joining Robertson Stephens in 1996, when he was 39 years old.

Starting over in an entry-level job is necessary, he added, because clinical experience doesn't translate to financial expertise. While his years of practice give him insight into the medical value and relevance of products, he said that the skills he uses as an analyst are different from those in play in medical practice.

"Both skill sets have a similar analytical shell," he said, but finance requires analysts to be able to evaluate management and business plans, as well as "sell" investment ideas to your own sales force. None of those skills, Dr. King said, were part of his medical training or experience.

And if you're troubled by the growing emphasis on productivity in medicine, the financial industry is not the place for you. "You're compensated and promoted based on business delivered in a tangible way that's followed quantitatively," Dr. King said. "You get paid according to how much business you bring through the door."

Internal medicine physicians are specialists who apply scientific
knowledge and clinical expertise to the diagnosis, treatment, and
compassionate care of adults across the spectrum from health to complex
illness. ACP Internist provides news and information for internists
about the practice of medicine and reports on the policies, products and
activities of ACP. All published material, which is covered by
copyright, represents the views of the contributor and does not reflect
the opinion of the American College of Physicians or any other
institution unless clearly stated.